Menvielle Gwenn
ERES-IPLESP Inserm, Sorbonne Université, Paris, France.
Rev Prat. 2020 Nov;70(9):957-959.
Social inequalities in health : an epidemiological perspective. Large social inequalities in mortality are observed in France as in most countries. In a context of decrease in mortality rates, the situation is encouraging among men, with a decrease over time of the difference in mortality between the most and least educated. On the contrary, social inequalities among women are on the rise, mostly due to trends in smoking-related mortality. The determinants of social inequalities in health are diverse and complex. Research is needed to precisely understand the mechanisms at stake and assess the role of the personal and work environment as well as the health care system, which are major determinants of social inequalities regardless individual behaviors.
流行病学视角。与大多数国家一样,法国在死亡率方面存在巨大的社会不平等。在死亡率下降的背景下,男性的情况令人鼓舞,随着时间推移,受教育程度最高和最低人群之间的死亡率差异有所减小。相反,女性中的社会不平等正在加剧,这主要归因于与吸烟相关的死亡率趋势。健康方面社会不平等的决定因素多种多样且复杂。需要开展研究以准确理解其中的关键机制,并评估个人和工作环境以及医疗保健系统的作用,这些因素是社会不平等的主要决定因素,无论个人行为如何。